How to Induce Arrhythmias with Adenosine?

Abstract

Adenosine is a nucleoside that is normally found inside the human body. It has a negative chronotropic and dromotropic effect. It slows the sinus node rate and also the conduction through the AV node. Adenosine’s mechanism of action is mainly on the sinus node and atrioventricular node. It stimulates the potassium current Ikr, Ado and Ach , inducing cellular hyperpolarization and blocking the conduction through the AV node with subsequent interruption of PSVT that is node-dependent. Adenosine can induce reentry using an accessory pathway. By slowing the anterograde conduction through the AV node, it allows retrograde activation of the atrium through the accessory pathway. Human studies have also demonstrated that adenosine administration reveals dormant PV conduction. The ADVICE trial demonstrated that 53% of the patients that received adenosine had dormant conduction.